1 ice for any acutely inflamed joint 2. phonophoresis with a hydrocortisone gel applied to the small joints of the hands 3. Heating to reduce morming stiffness 4 .Gentle, passively performed stretching exercises to passive range of motion 5.lsometrically performed toning exercises, especially for the large and medium-sized joints 6.Occupational therapy(specialized splints, occupational aids) 7.Low-impact aerobic exercises as tolerated